For Urination Problems after Cancer Treatment, MSK Surgeons Can Help

By Jennifer Castoro,

Monday, January 26, 2015

Pictured: Jaspreet Sandhu and Laura Leddy
Summary

Urinary problems like incontinence and overactive bladder can be an issue for cancer survivors. At MSK, our surgeons can offer a range of solutions.

Side effects of cancer therapies, including complications such as incontinence and bladder issues, can have a negative impact on quality of life for people with the disease as well as survivors. And for a myriad of reasons — not wanting to continue seeing a doctor, not knowing help is available, shame or embarrassment in discussing symptoms — they often don’t seek relief.

At Memorial Sloan Kettering, urologic surgeons Jaspreet Sandhu and Laura Leddy are hoping to change that outcome. They’re two of just a handful of surgeons across the United States who specialize in treating the urinary issues that can plague survivors of prostate cancer, colorectal cancer, and other diseases that cause damage to the urinary system.

These solutions can offer significant relief for these devastating problems and allow patients to return to their normal routines.

Some of the more common urinary problems caused by cancer treatments or surgeries:

  • incontinence
  • retention (the inability to empty the bladder completely)
  • overactive bladder
  • scarring of the urethra, known as urethral stricture
  • bladder and urethral fistulas (abnormal openings or passages resulting from treatment)

The procedures Drs. Sandhu and Leddy offer include:

  • medical, behavioral, and surgical treatment for men and women with incontinence and overactive bladder
  • laser prostate surgery for enlarged prostate
  • repair of urethral strictures and reconstruction for both male and female fistulas

An Unspoken, or Misspoken, Issue

Because urinary dysfunction is an uncomfortable topic for many people, they often hide the debilitating symptoms and simply keep quiet about their distress.

There are many surgical and nonsurgical treatments we can offer.
Jaspreet Sandhu MSK urologic surgeon

“Patients may feel that they have to live with the side effects of their cancer therapy,” Dr. Leddy explains, but that isn’t the case. “We focus on helping people get back to feeling like themselves.”

People may also get misinformation about what options are available to them. “Patients have been told there’s no solution,” Dr. Sandhu says. “They’ve been told that it’s normal to have these symptoms. But there are many surgical and nonsurgical treatments we can offer.”

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Urinary Symptoms Affect a Range of Survivors

Though the spectrum of problems is relatively broad, treatments such as behavioral therapies, medications, and an array of surgical therapies can help solve many of them.

The doctors see a wide variety of patients, from those with cancers directly affecting the urinary system such as prostate and bladder, to others whose cancers are indirectly related, like colorectal and gynecologic cancers. People receiving hormone therapy for breast and prostate cancer can also be affected.

“We’re comprehensive, not only from what we offer but from what type of patients we see,” says Dr. Sandhu. “We see the whole gamut.”

The breadth of cases has given the doctors an expertise that can’t be matched at many other places. “Most centers don’t have anyone doing some of these procedures,” says Dr. Sandhu. “We have two.”

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Help for All, Now and in the Future

Because these types of complications can crop up during, immediately after, or long after treatment for cancer, the team is ready and willing to see patients from the beginning of their cancer journey through as long as they’re needed.

People think, Well, I don't have cancer anymore. They don't realize they have options.
Laura Leddy MSK urologic surgeon

“We treat patients at all levels,” says Dr. Sandhu, “not only before their primary treatment but also during primary treatment, after primary treatment, after secondary treatment, or after we or somebody else has taken care of their problems and they have further problems.”

“People think, Well, I don’t have cancer anymore. They don’t realize they have options,” says Dr. Leddy.

The doctors also want to spread the word that their services are open to those who received treatment for cancer elsewhere. “We are a resource, and we want people to come,” says Dr. Sandhu. “Even if they weren’t treated at MSK, people can still seek treatment here.”

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Comments

I am currently a patient at Mayo Clinic. I had cervical cancer, which I no longer have, but I do have a bladder fistula. I have bilateral nephrostomy tubes, and am undergoing hyperbaric treatment, although my doctors are not optimistic that we can repair the fistula. I am only 29 years old, so I would like to see what my options are, if any. Thank you

I had a radical prostatectomy in 2005. I developed scar tissue over the years and had a cystosopy on August 2, 2016. That was unsuccessful. I had urethroplasty on 11/28/2016. I had another cystopopy on 6/19/2017. I was diagnosed with urithriel stricture disease. I have another appointment in late September. I would like to send my records to you for a second opinion, but would like to wait until my next appointment to schedule an appointment with Dr. Sandhu. All my procedures were done at the University of Rochester Medical center Urology department, Rochester NY. My Doctors name is Dr. Warren. Would you accept me for a second opinion, and if so, can I have my records sent to you.

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